Although breast cancer remains a significant cause of death in women, mortality from breast cancer has been decreasing slightly over the past decade. There may be many reasons, including recognition of the relationship between oral estrogen and breast cancer, as well as improved medical treatment of cancer patients. There is also deepening understanding of breast cancer genetics and of the types of disease and treatments. In addition, the guidelines for screening continue to evolve, including recommended imaging procedures.
The United States Preventive Services Task Force recommends optional screening every two years for women aged 40 to 49 and screening every two years for women 50 to 74. Women with a family history of breast cancer should start screening earlier and possibly yearly rather than biennially. Women with dense breasts may have elevated risk of breast cancer, but they are not considered to be in the high-risk category. Although certain factors may increase risk, it’s important to note that 85 percent of women diagnosed have no family history.
Physical examination and mammography remain the mainstays of breast cancer diagnosis, though other diagnostic imaging procedures may be used. Ultrasound is a wonderful guiding tool to aid in the biopsy of breast nodules, using sound waves to evaluate palpable masses or lesions seen with mammography. However, on its own, it’s not recommended as a screening modality. Younger women with a palpable mass should first be evaluated with ultrasound, since a simple cyst is benign and needs no further imaging. For women over 35, mammography and ultrasound are appropriate for evaluating a palpable mass.
The utility of magnetic resonance imaging (MRI) in breast imaging is still being evaluated. It’s occasionally recommended for breast lesions that are difficult to categorize by mammography or ultrasound. MRI can also be used to determine the extent of disease in women with biopsy-proven breast cancer prior to surgical therapy. It also provides another means of imaging very dense breasts or breasts with implants. Like ultrasound, it’s not recommended as a screening method in lieu of mammography.
Different diagnostic imaging techniques may be helpful in finding a diagnosis, and your doctor will make that determination. As the patient, your job is to get to know your breasts so you can identify any unusual changes. Find a physician that you trust and follow their advice.
The Casa Colina Diagnostic Imaging Center makes the testing process faster and easier for patients while providing optimal diagnostic images. The Center offers board-certified radiologists, highly trained and credentialed professionals, same-day/next-day appointments, and Spanish-speaking staff. Most insurance plans are accepted. To learn more or to schedule an appointment, call the Casa Colina Diagnostic Imaging Center at (909) 450-0395.
Gary Jensen, MD, is board-certified with the American Board of Radiology at Casa Colina Diagnostic Imaging Center